Matchstick Men

Introduction

Matchstick Men, directed by Ridley Scott, was
released in 2003 and is based on the book by Eric Garcia called
Matchstick Men: A novel about Grifters with Issues. It is
a film about confidence tricksters in which the main protagonist, a
con artist called Roy, is convincingly played by Nicolas Cage as a
man who suffers from Tourette’s syndrome and obsessive-compulsive
disorder. There are two themes in this film that run alongside each
other: a clever story of conmen, filled with the expected twists
and an impressive final ‘sting’, and a deeply personal tale of a
man struggling to cope with serious mental illness who is
challenged by the appearance of a teenage daughter he didn’t know
existed.

Matchstick Men also presents us with an
interesting portrait of a psychiatrist, Dr Klein, whom Roy visits
for help with his condition. This is a film about deception and
disclosure in various settings and relationships and offers much
for the viewer interested in how we assess the truth about what we
are told.

The Film

For anyone who hasn’t yet seen the film and doesn’t
want the plot revealed, please do not read on until viewing it.

Matchstick Men opens with Roy, at home,
suffering with his numerous obsessive compulsive symptoms, which
take the form of a need for order and cleanliness and a compulsion
to open and close doors three times, whilst counting aloud, before
he can walk through them. His Tourette’s syndrome consists of a
facial tic involving mostly his left eye and audible grunting. In
the following scenes, we watch Roy and his partner in crime, Frank,
play out a ‘short con’ on an unsuspecting housewife. Roy is exposed
to bright sunlight, when a door is opened to her garden, which
triggers an increase in his facial tics, grunts and then the onset
of a panic attack.

Roy takes regular medication for his symptoms, but
despite this treatment he lives a lonely life and seems unable to
act on a clear attraction, apparently reciprocated, toward a
cashier at his local supermarket. Although Frank is seen to be
generally supportive and tolerant of Roy’s symptoms, he
occasionally finds pleasure in upsetting him by deliberately
defying his need for cleanliness. Matchstick Men creates a
tremendous tone of anxiety for the viewer in the scenes in which
Roy struggles to control his world. His smoking, an attempt to self
medicate, increases as he becomes more stressed and anxious and is
at times almost unbearable to watch, especially in the confined
space of his car.

When Roy accidentally loses the remaining supply of
his psychiatric medication down the waste disposal unit of his
sink, a comic element is briefly added to the film, soon followed
by Roy’s horror and despair when he finds that the doctor, who was
supplying them illegally, has moved away. Without medication, his
symptoms worsen, such that Frank arranges for him to see a
psychiatrist he knows called Dr Klein. In the first meeting with Dr
Klein, Roy begs for just a few tablets. Dr Klein refuses and
insists on a proper assessment, during which Roy reveals that he
has been without an intimate partner since leaving his wife almost
15 years before and that his wife had been pregnant when they
parted. Roy, uncertain as to whether he had been the father of the
baby, becomes curious to know whether he now has a 14 year-old
child. Dr Klein supplies Roy with some different pills, that he
believes will help him to feel much better, and says he will
contact his ex-wife on his behalf. The new pills appear to help
improve all of Roy’s symptoms. After learning that has a daughter,
called Angela, who would really like to meet him, Roy is challenged
by his newfound role as her father and his obsessive-compulsive
disorder is tested to its limits by her visits to his house. As he
struggles to cope with a messy teenager in his life he also becomes
aware of the positive emotional effect that she is having in his
sterile life. Faced with the dilemma of whether he should tell her
the reality about his work, she makes some discoveries in his home,
which force him into telling her the truth.

As Angela learns about her father’s real profession
and the amount of money that he has made from it, she asks to learn
the trade from him. Wanting to keep her presence in his life, he
reluctantly agrees. Caught up in the wish to please Angela, he
reluctantly teaches her how to carry out a simple ‘con’, but forces
her to return the money to the victim after it has been
successfully completed. Frank, by this stage, has persuaded
Roy to carry out a ‘long con’ with him, that promises to extort a
much larger sum of money from a businessman that Frank has met.
Contrary to Roy’s wishes, Angela becomes involved in the final part
of the operation, which goes very wrong. On returning home, Roy and
Angela find the business man holding Frank hostage and he requests
all of the money that Roy has in the house. When Angela goes to get
the money, she returns with a gun and shoots the businessman. Frank
and Angela drive away at Roy’s request before he receives an
unexpected blow to the head from the businessman. As Roy wakes up
in a hospital bed, he is questioned by police officers, but refuses
to answer anything until he can see his psychiatrist. When Dr Klein
arrives at his bedside he whispers the pass code for his bank vault
box and asks that it be given to his daughter. It is only when Dr
Klein has left and no one else returns that Roy gets up and opens
his hospital room to reveal that he is on the roof top of a tall
building and is himself the victim of an audacious sting carried
out by Frank, with the help of a fake daughter, psychiatrist and
businessman. However, one year later, after having lost all of his
money, Roy has found love and marriage with the cashier, who is now
pregnant with their first child. He is also honestly employed as a
carpet salesman and suffers far fewer symptoms.

Relevance to the field of Mental Health

The subject of OCD has been covered in my
previous Minds on Film blog about
The Aviator and I would refer readers, wanting more
information about OCD, to that post. In the character of Roy, there
is ample opportunity to examine the day-to-day effect that
obsessive-compulsive disorder might have on an individual and their
relationships. However, Matchstick Men also introduces
viewers to one of the conditions commonly associated with OCD,
Tourette’s syndrome. This is a neurological condition characterised
by involuntary, random sounds and movements, known as tics, which
usually begins in childhood. It is thought that up to 60% of
children with Tourette’s syndrome develop OCD. The tics are often
used to relieve uncomfortable feelings or sensations and many
people are unaware of their tics. In Roy’s case his tics and grunts
are seen to be closely linked to his level of anxiety, something
that is well recognised in sufferers generally. His vulnerability
at the hands of others reminds us of the predicament that many
people with mental illness live with. It is only when Roy has
abandoned his stressful life of crime and finds a meaningful loving
relationship, that he is able to overcome the most distressing
symptoms of both of his disorders.

There is excellent information about all aspects of
Tourette’s syndrome at the NHS Choices website, including a
discussion about the co-morbidity with OCD and ADHD, and
further advice is available at the website of the charity Tourettes
Action. Medication does have a role
in treating some of the symptoms of Tourette’s syndrome and there
are three types of drugs that may be used: alpha2-adrenergic
agonists; muscle relaxants and neuroleptics. Behaviour therapy is
the widely used non-pharmacological treatment of choice, which can
be used alone or with drugs depending on the severity of the
symptoms. Through using relaxation and a technique called habit
reversal many people with Tourette’s syndrome are enabled to manage
their symptoms better.

I would highly recommend Matchstick Men to
anyone interested in working in Adult Mental Health, whether in
psychiatry, psychiatric nursing, psychology or in any of the
branches of psychotherapy.

• Minds on Film is written by Consultant
Psychiatrist, Dr Joyce Almeida.

• More information about Matchstick
Men is available at IMDB,
as well as a short
trailer.

Comments

Re: Matchstick Men

03/06/2015 22:30:43 by Zhanna & Dennis

Dear Dr Almeida,

Thank you very much for introducing me to your interesting and
useful blog. From now on you will have us as regular visitors. We
have just watched this film which proved my belief that a clean
conscience can boost a person's "immune system". Thank you